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Risk management for people with inherited  mutations

The National Comprehensive Cancer Network (NCCN) provides risk management guidelines for men and women with mutations. We recommend that you speak with a genetics expert who can look at your personal and family history of cancer and can help you determine the best risk management plan. You can learn more about risk management options in our section on Screening and Risk Reduction by Cancer Type.

People with a  mutation may also qualify for clinical trials looking for more effective screening or prevention for cancer. 


Gastric cancer screening and prevention

  • Experts recommend that people with an inherited mutation have risk-reducing surgery to completely remove the stomach (prophylactic total gastrectomy) between ages 18 and 40. Stomach removal is not recommended for people younger than age 18, but may be considered for certain patients, especially those with family members diagnosed with gastric cancer before age 25. An upper endoscopy should be performed before surgery. Upper endoscopy involves passing a tiny scope with a video camera down the esophagus to the stomach. 
  • mutation carriers who have not had their stomachs removed should have screening every 6-12 months by upper endoscopy with multiple random biopsies. This allows doctors to look closely at the stomach. The surgeon can pass a tiny instrument through the scope to take tissue samples from the stomach that can be checked for cancer. 


Breast cancer screening and prevention

  • Yearly  with (3D mammograms) and consider yearly breast MRIs with contrast beginning at age 30 or earlier based on family breast cancer history.
  • Discuss option of risk-reducing mastectomy.


Other cancer screening and prevention

There has not been enough research to show a benefit from screening and prevention for other cancers in people who have a  mutation. For this reason, experts recommend managing these risks based on family history of cancer.  Cancer screening and prevention research studies may be available for people with an inherited  mutation. 

Last updated September 19, 2022

Get Support
Get Support

FORCE offers many peer support programs for people with inherited mutations. 

updated: 08/06/2022

Paying For Care
Paying For Care

Health plan coverage of screening and prevention varies, and deductibles, coinsurance and copays often apply. If you need preventive services and your insurance company denies your claim, your health care provider can help you write an appeal letter, or you can use one of our sample appeal letters. If you need information about finding an insurance plan, watch our video: Choosing Wisely: How to Pick Insurance Plans.

Visit our section on Insurance and Paying for Care: Screening and Prevention for more information. 

updated: 11/15/2022

Open Clinical Trials
Open Clinical Trials

updated: 03/13/2022